scholarly journals CT Findings of Acute Stroke– Study of 321 Cases

2019 ◽  
Vol 32 (1) ◽  
pp. 17-24
Author(s):  
Md Durrul Huda ◽  
Niranjan Kumar Saha ◽  
Quamruddin Ahmad ◽  
Md Kafil Uddin ◽  
Md Munzur Alahi ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Neurological Diseases ◽  
Adult Life ◽  
Ct Scanning ◽  
Haemorrhagic Stroke ◽  
Cranial Computed Tomography ◽  
Intravenous Contrast ◽  
Ct Findings ◽  
Stroke Study ◽  
Monitoring Devices

Stroke ranks first in frequency among all the neurological diseases of adult life and about 50% of all neurological disorders in a hospital are of this type. It is the third leading cause of death throughout the world. The purpose of the present study was to find out the presence or absence of haemorrhage or infarct and to detect the early signs of stroke on the basis of CT scanning. Three-hundred twenty one consecutive acute stroke patients (mean age 64 ±9.75 years) were included in our study. Each underwent cranial computed tomography without intravenous contrast injection within the first 24 hours. CT findings of stroke were analyzed using SPSS software. Among 321 patients, 209(65.11%) had ischemic stroke, 99(30.84%) had parenchymal haemorrhage and 13(4.05%) had subarachnoid haemorrhage. Total amount of haemorrhagic stroke was 112(34.89%). Early CT findings of ischaemic stroke were low attenuation area (83.25%), sulcal effacement (69.89%), loss of the insular ribbon (17.70%), hyperdense artery sign (1.43%). CT scanning should be the first line of investigation for diagnosis of acute stroke as it is more available than MRI and is easily performed in severely ill patients who are dependent on support and monitoring devices TAJ 2019; 32(1): 17-24

scholarly journals Review of major trials of acute blood pressure management in stroke

2021 ◽  
pp. 0271678X2110043
Author(s):  
Thompson G Robinson ◽  
Jatinder S Minhas ◽  
Joseph Miller
Keyword(s):  
Blood Pressure ◽  
Clinical Trials ◽  
Acute Stroke ◽  
Trial Design ◽  
Haemorrhagic Stroke ◽  
Pressure Management ◽  
Blood Pressure Management ◽  
Multiple Trials ◽  
Hypertensive Crises ◽  
Improve Patient

Over the last two decades, there have been a number of major landmark clinical trials, classified as “major” as they sought to address clear clinical practice driven questions, in a pragmatic yet robust trial design, using a large powered sample size (n > 1000), in order to help improve patient outcome through informing guidelines. A commonality across all stroke sub-types included in these trials is the tendency to acute hypertensive crises within the acute stroke period. This phenomenon is associated with greater stroke complications and worsened overall prognosis. Multiple trials have attempted to address the issue of acute blood pressure management during the acute stroke period, with consideration for timing, magnitude of lowering, agent and relationship to other interventions. This review will consider the major clinical trials performed in ischaemic and haemorrhagic stroke that test the hypothesis that acute BP reduction improves clinical outcomes.

Progressive neurological deficits with benign intracerebral cysts

1986 ◽  
Vol 65 (5) ◽  
pp. 706-709 ◽  
Author(s):  
Yoko Nakasu ◽  
Jyoji Handa ◽  
Kazuyoshi Watanabe
Keyword(s):  
Histological Examination ◽  
Computerized Tomography ◽  
Cyst Wall ◽  
Benign Lesion ◽  
Ct Scanning ◽  
Neurological Deficits ◽  
Review Of The Literature ◽  
Content Type ◽  
Ct Findings ◽  
Fine Print

✓ Two patients with benign intracerebral cysts are reported and a brief review of the literature is given. Although computerized tomography (CT) scanning is useful in detecting a variety of intracerebral cysts, the CT findings are not specific for any lesion. An exploratory operation with establishment of an adequate route of drainage and a histological examination of the cyst wall are mandatory in the management of patients with a progressive but benign lesion.

Physical Activity, Physical Function, and Quadriceps Muscle Thickness in Male Patients with Sub-Acute Stroke during Hospitalization: A Pilot Study

2018 ◽  
Vol 80 (3-4) ◽  
pp. 157-162 ◽  
Author(s):  
Masafumi Nozoe ◽  
Hiroki Kubo ◽  
Asami Furuichi ◽  
Masashi Kanai ◽  
Miho Yamamoto ◽  
...  
Keyword(s):  
Physical Activity ◽  
Acute Stroke ◽  
Physical Function ◽  
Muscle Thickness ◽  
Haemorrhagic Stroke ◽  
Quadriceps Muscle ◽  
Stroke Recurrence ◽  
Daily Number ◽  
Paretic Side ◽  
Male Patients

Increasing physical activity (PA) is an important rehabilitation target for patients with sub-acute stroke during hospitalization in order to recover physical function and prevent stroke recurrence. However, the characteristics of low PA in stroke patients during hospitalization who were targets for increased intervention have not been reported. The purpose of this study was to investigate the relationship between the daily number of steps and physical function and quadriceps muscle thickness (QMT) in patients with sub-acute stroke during hospitalization for convalescence rehabilitation. Twenty-nine patients with ischemic or haemorrhagic stroke (mean age, 69 ± 11 years) hospitalized for inpatient convalescent rehabilitation were included. PA was measured using a three-dimensional accelerometer that calculates the daily number of steps taken. Physical function was measured by a short physical performance battery (SPPB; 0–12 points) and the leg motor selectivity score (6 motor stages defined by Brunnstrom), and the QMT of both legs was measured using ultrasonography. PA was significantly correlated with the SPPB score (r = 0.63, p = 0.0002), QMT on the paretic side (r = 0.41, p = 0.02), and QMT on non-paretic side (r = 0.56, p = 0.002). There were no significant effects of the leg motor selectivity score on daily PA (F = 1.37, p = 0.27). In the multiple regression analysis, only the SPPB score showed significant linear regression (β = 0.44, p = 0.02). PA in male patients with sub-acute stroke during hospitalization was related to physical function and QMT and not with the severity of paresis.

Timing of Aspirin and Secondary Preventative Therapies in Acute Stroke: Support for Use of Stroke Units

2005 ◽  
Vol 50 (2) ◽  
pp. 69-72 ◽  
Author(s):  
J Reid ◽  
M-J MacLeod ◽  
D Williams
Keyword(s):  
Acute Stroke ◽  
Ct Scanning ◽  
Medical Ward ◽  
Stroke Patients ◽  
Stroke Units ◽  
General Medical Ward ◽  
Brain Scans ◽  
Angiotensin Ii Antagonist ◽  
Acute Stroke Unit ◽  
Ct Brain

Background: We aimed to study the timing of aspirin prescription in ischaemic stroke comparing patients admitted to an acute stroke unit (ASU) directly or via a general medical ward. We also analysed prescription of secondary preventive therapies in stroke patients in an ASU. Methods: Retrospective analysis was made of medical notes and prescription records of 69 patients admitted to an ASU over a three month period to establish timing of aspirin prescription with respect to onset of stroke symptoms, CT brain scan and route of admission to the ASU. Results: CT brain scans were obtained at a median of 2.1 days post stroke (IQ range 1.3–4.3). Patients directly admitted to the ASU received aspirin earlier post admission compared to those admitted via a medical ward (0.7 vs 2.2 days, p<0.01) and were also more likely to receive aspirin prior to CT scan being performed (57% vs 19%, p=0.02). 86% of stroke patients were discharged on an antiplatelet therapy, 79% on a statin, 37% on a thiazide diuretic and 32% on an ACE inhibitor or angiotensin II antagonist. Conclusion: Aspirin was given more promptly in acute stroke and more commonly prior to CT scanning in an ASU compared to a medical ward. Statin therapy is used extensively in stroke but there is a much lower rate of initiation of other secondary preventive therapies (e.g. anti-hypertensive therapy) in hospital. These findings demonstrate a hesitancy in early use of aspirin amongst general physicians and lends support for the use of stroke units.

Acute stroke: usefulness of early CT findings before thrombolytic therapy.

Radiology ◽  
1997 ◽  
Vol 205 (2) ◽  
pp. 327-333 ◽  
Author(s):  
R von Kummer ◽  
K L Allen ◽  
R Holle ◽  
L Bozzao ◽  
S Bastianello ◽  
...  
Keyword(s):  
Thrombolytic Therapy ◽  
Acute Stroke ◽  
Ct Findings

Multi-Modal CT in Acute Stroke: Wait for a Serum Creatinine before Giving Intravenous Contrast? No!

2015 ◽  
Vol 10 (7) ◽  
pp. 1014-1017 ◽  
Author(s):  
Timothy E. Ang ◽  
Andrew Bivard ◽  
Christopher Levi ◽  
Henry Ma ◽  
Chung Y. Hsu ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Acute Stroke ◽  
Intravenous Contrast

Relevance of early head CT scans following neurosurgical procedures: an analysis of 892 intracranial procedures at Rush University Medical Center

2014 ◽  
Vol 121 (2) ◽  
pp. 307-312 ◽  
Author(s):  
Ricardo B. V. Fontes ◽  
Adam P. Smith ◽  
Lorenzo F. Muñoz ◽  
Richard W. Byrne ◽  
Vincent C. Traynelis
Keyword(s):  
Operating Room ◽  
Neurological Examination ◽  
Medical Center ◽  
Ct Scanning ◽  
Ct Scans ◽  
Type I ◽  
Type Ii ◽  
Head Ct ◽  
Ct Findings ◽  
Neurological Change

Object Early postoperative head CT scanning is routinely performed following intracranial procedures for detection of complications, but its real value remains uncertain: so-called abnormal results are frequently found, but active, emergency intervention based on these findings may be rare. The authors' objective was to analyze whether early postoperative CT scans led to emergency surgical interventions and if the results of neurological examination predicted this occurrence. Methods The authors retrospectively analyzed 892 intracranial procedures followed by an early postoperative CT scan performed over a 1-year period at Rush University Medical Center and classified these cases according to postoperative neurological status: baseline, predicted neurological change, unexpected neurological change, and sedated or comatose. The interpretation of CT results was reviewed and unexpected CT findings were classified based on immediate action taken: Type I, additional observation and CT; Type II, active nonsurgical intervention; and Type III, surgical intervention. Results were compared between neurological examination groups with the Fisher exact test. Results Patients with unexpected neurological changes or in the sedated or comatose group had significantly more unexpected findings on the postoperative CT (p < 0.001; OR 19.2 and 2.3, respectively) and Type II/III interventions (p < 0.001) than patients at baseline. Patients at baseline or with expected neurological changes still had a rate of Type II/III changes in the 2.2%–2.4% range; however, no patient required an immediate return to the operating room. Conclusions Over a 1-year period in an academic neurosurgery service, no patient who was neurologically intact or who had a predicted neurological change required an immediate return to the operating room based on early postoperative CT findings. Obtaining early CT scans should not be a priority in these patients and may even be cancelled in favor of MRI studies, if the latter have already been planned and can be performed safely and in a timely manner. Early postoperative CT scanning does not assure an uneventful course, nor should it replace accurate and frequent neurological checks, because operative interventions were always decided in conjunction with the neurological examination.

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